Several years ago, Riko Miyauchi’s dream of becoming a doctor took her into the exam halls of one of Japan’s most prestigious medical schools.

As a young woman, she knew her prospects were slim. Tokyo Medical University’s entrance exam was notoriously tough, with women far less likely to pass than men.

Unknown to Miyauchi, the university’s authorities had put another barrier in her way. She is one of an unknown number of young women whose test scores the school deliberately marked down to prevent them entering a career in medicine and ensure more men became doctors.

The revelations have generated negative headlines around the world and prompted the education ministry to order an urgent investigation into suspected institutional sexism at dozens of medical schools.

“There were rumours that the school deliberately failed women so they could produce more male doctors,” Miyauchi, one of the first affected women to speak publicly, said in an interview with the Guardian. “But I was still shocked when I found out that those rumours were true.”

The rigging of exam results was uncovered during an investigation into the alleged backdoor entry of an education ministry bureaucrat’s son in exchange for favourable treatment towards the school in obtaining research funds.

The investigation found that in this year’s entrance exams the school reduced all applicants’ first-stage test scores by 20% and then added at least 20 points for male applicants, except those who had previously failed the test at least four times.

The scandal has received scathing media attention and prompted a public apology from the university, which acknowledged that the practice of altering candidates’ scores based on their gender started in 2006.

Suspicions are growing that other medical schools also discriminate against female candidates.

Sayumi Tanaka, who sat the Tokyo medical school’s exam a few years ago, said she felt betrayed when she learned she was among those whose test scores had been manipulated.

“Changing people’s test scores because of their gender is straightforward discrimination,” she told the Guardian. “There is a huge difference between changing an exam score and giving someone a poor evaluation in an interview, because in the latter the examiner has more of a free hand.”

Tanaka, who is planning a career in psychiatry, is one of several women who are considering a compensation claim. “I want them to return the money I spent on the entrance exam,” she said. “If I had known that the school discriminated against female candidates I would never have applied.”

The revelations have underlined the considerable obstacles facing Japanese women aspiring to become doctors. According to admissions records released by the school, the percentage of women who passed the entrance exam rose from 24% in 2009 to 38% in 2010, but the rate has fallen since then and stood at 18% this year.

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A similar story has unfolded nationwide. Although the number of female students in medical schools rose sharply between in the decade up to 1997, it has remained stuck at just over 30% for the past 20 years.

The dearth of female doctors has left Japan trailing well behind other advanced economies. According to OECD data, in 2015 Japan had 67,493 female doctors, or just over 21% of the total - less than half the OECD average of almost 45%.

“I didn’t have any concrete evidence, but something felt off,” Kyoko Tanebe, an obstetrician and the director of the Japan Joint Association of Medical Professional Women, said of the rigged entrance exams.

The root of the problem lay in the belief that male doctors are better placed to put in the long hours necessary to keep Japan’s pressurised healthcare system afloat, she told the Mainichi newspaper. “Now that we have opened this Pandora’s box, there needs to be a national discussion about what should be done on the floors of hospitals and other medical facilities.”

The scandal is an embarrassment to the prime minister, Shinzo Abe, who has made increasing the number of women in the workforce a pillar of his growth strategy. While women now account for more than 40% of the workforce, they are underrepresented in politics, company boardrooms and professions such as medicine. In 2017, the World Economic Forum ranked Japan 114th out of 144 countries in terms of gender equality, down 23 places from a decade ago.

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Tanaka and Miyauchi, who had both accepted offers from other medical schools before their Tokyo exam results were compiled, hope the anger evident in social media and during a protest in front of the school last week will turn into a movement to force university authorities to change their ways.

“The medical school said it manipulated exam scores to ensure a steady supply of [male] doctors for its affiliated hospitals,” said Tanaka. “Their policy was not to support female doctors but simply to give more jobs to men. That isn’t going to help solve the labour shortage in the medical profession.”

Miyauchi, who hopes to work in a hospital emergency room, said the test score scandal risked deterring girls from entering the medical and other professions.

“It reinforces the message that women don’t need to bother studying,” she said. “The old-fashioned idea that women should raise children while their husbands go out to work still resonates in Japanese society. This is just an example of a much bigger problem. And it’s brought shame on Japan.”